HUNDREDTH VOLUME

Abstract

The first journal was published just after the end of Queen Victoria's reign. Stability had ruled for forty years and from Britain obstetricians turned to Europe for intellectual and technical stimulation; American medicine followed rather than led. It was a brave group of doctors who in 1902 put up the money to start a journal in what was a small speciality in a small island. Now, with numbering not being precisely annual, we have reached the hundredth volume and it is time to take stock. The world is a more unstable place. European medicine has lost its lead and Americans fuel the fires. In Britain, the subject of Obstetrics and Gynaecology is under pressure from educationalists and politicians, from the altruists on one hand who tell us we are too technical and not human enough to the epidemiological purists on the other hand who berate us for not following the results of randomised controlled trials and of being too human. The British Journal of Obstetrics and Gynaecology has reflected all these changes and Sir John Peel traces them in his review of the history of the Journal (p. 2). We reproduce also what the contemporary British Medical Journal and the Lancet said about our first number (p. 9). The style of our Journal follows fashion like any other dynamic organisation. The first cover, which we have reproduced, is overcrowded in heavy Gothic style to get every possible fact on to the front page. It resembles the shop window of the village grocer. The current cover is startlingly simple and reflects the design ideas of the 1990s, looking more like an Italian racing motor car. Between the covers, the more anecdotal events of clinical practice have given way to objectively judged scientific material. We started the century with one man's account of a hundred cases of women with fibroids and end with randomised placebo controlled trials assessing pharmacological marvels. We reproduce two previous Journal articles, on ergometrine by Chassar Moir and C. S. Russell and ultrasound by Ian Donald; we consider these amongst the most important in the last ninety years, for each led to major changes in practice. To choose them we read widely in the previous ninety-nine volumes and selection was difficult, being dictated more by the pages available than the number of seminal articles. It was interesting, however, to note that events such as the early use of antibiotics for puerperal pyrexia or of gynaecological laparoscopy had their first publications in other journals and only after a couple of years was material available to the British Journal of Obstetrics and Gynaecology. Perhaps this reflects the more drawn out processing of articles in a monthly journal; the immediacy of the weekly journals influenced authors keen to see their innovations in print more promptly. The Journal editors have distanced their protegé from the wider social and political world; we searched in vain for comment on the foundation of the College of Obstetricians and Gynaecologists, the Second World War or the introduction of the National Health Service. Even the obituary columns were stopped and the Journal has kept to the science of Obstetrics and Gynaecology within its covers. For the future we hope that the British Journal of Obstetrics and Gynaecology will reflect the world of Obstetrics, its science, its work and the Royal College which guides and guards British Obstetrics. We will keep the scientific standards at the high levels to which previous editors have raised them and add other material slowly during the next years. The changes that we will reflect in Obstetrics and Gynaecology before the turn of the century are likely to be greater in the practice of the subject than any other that has occurred in the last ninety years. It is right therefore, that the Journal should have some reporting of these, rather than just the scientific measurement of Obstetrics and Gynaecology. As well as changes in clinical treatment, there will be much alteration in the management of obstetricians. Education, service commitments and work patterns will be altered so much in the next few years that the Journal should rightly keep its readers, in Britain and beyond, aware of some of these changes in which the Royal College is taking an active role. We look towards exciting days; the science of Obstetrics and Gynaecology has bloomed actively and will go on so doing, whilst the art of the subject will expand also. Both of these will take place inside the changes which society will provide. These are in two parts, the micro-environment of the hospitals and universities within which we work and the larger environment of the community we serve. All these variables need to be reflected in a balanced journal.